An External Cephalic Version (ECV) Success Story!

I haven't posted in quite a while, mostly because, well, carving out time for blogging has been at the bottom of my priority list! With a toddler to care for, a baby on the way, and the many tasks of a homemaker, I have to be very particular about how I spend any "free time," and sorry, folks, but blogging didn't make the cut!

However, I wanted to write a post about this, because I myself had spent a lot of time scouring the internet for information, stories, experiences, anything regarding the procedure called the External Cephalic Version, often shortened to "External Version," "Version," or "ECV." I thought perhaps writing my experience would encourage any other moms faced with this procedure!

At 28 weeks and 3 days, I had an ultrasound of our sweet baby girl which showed her doing extremely well, and head down! I was very happy to hear that, because I was looking forward to a drug-free natural delivery and I knew the only thing that could possibly derail those hopes was a breech presentation.

Then at my routine appointment two weeks later, I asked the OB to feel for her position (just to make sure she was still head down) ... and to my surprise, the doctor said it felt like she was breech, with her little head under my right ribs. That didn't worry me too much, because I knew that babies often change positions and it really doesn't become a concern at all until 34 weeks. I was surprised, though, because though our baby girl has been very active, I didn't notice any "extreme" movements that would have clued me in to the fact that she had flipped to breech.

After another routine growth ultrasound at 33 weeks, a few more routine appointments, and another ultrasound to confirm her position earlier this week, we realized that baby girl was still in the frank breech position. At this point in the pregnancy, every day she didn't flip decreased her chances of turning on her own. Since the baby grows bigger, there becomes less and less room for her to turn. There is still a chance she could turn, and there are TONS of stories of babies who have turned late in the game (even during labor!) but for all intents and purposes, at this point in the pregnancy, she probably wouldn't turn on her own. So it looked like my baby girl fell into the approximately 4% of babies that end up in the breech position at term! That means two options: a scheduled c-section, or an ECV.

(Although babies can be safely birthed naturally in the breech position, not many OBs or midwives are trained to do so, and my practice isn't. Even if they were, however, I would not be a good candidate for that for a few medical reasons, so while some women may have three options--ECV, c-section, or breech birth--my situation was one in which I really only had two.) 

I had learned about ECVs long before I knew our baby girl was breech; when you look up information about breech presentation, you're bound to find information on ECVs as well. There are lots of "at-home" things you can do to encourage a baby to turn head down: inversions, using a cold pack/music/flashlights on the top of your belly, swimming, finding a chiropractor trained in the Webster technique, etc. etc. (For those interested in these techniques, the best resource out there on the subject is http://www.spinningbabies.com). I had tried everything! From what I had read, it seemed as though the "last resort" is the ECV, and not all OBs will offer it since not all of them are trained in how to do it. I was very grateful when I learned that two of the OBs at my practice do!

So what is the External Cephalic Version? Basically, it's a procedure where the doctor tries to manually flip the baby to the head down position by manipulating the mom's belly from the outside. It's done in a hospital setting, because although it is generally considered a safe procedure, there can be risks to the baby, like fetal distress, placental abruption, cord entanglement, etc. The baby is monitored very closely via ultrasound before, during, and after the procedure to make sure none of those things occur or have occurred. If they do, then the mom can be rushed in for an emergency c-section. It is usually done around 36-37 weeks: before then, though the baby is smaller and would be easier to flip, the odds of them going back to the breech position are higher, and if a c-section became necessary, the baby would be more premature than the doctors would want. Later than that, the baby is bigger and harder to turn. Although 36-37 weeks wouldn't be the ideal time for the baby to be born (39+ weeks is generally the "gold standard" when it comes to that!) ... it's the best "window" that takes into account the health of the baby and the possibility of a successful flip.

After my ultrasound on Monday, it was decided that we'd schedule the ECV for Wednesday; I'd be 36 weeks, 5 days pregnant. 

Because of the possibility (however slight) that a c-section could be needed, I was not allowed any food or drink for 6-8 hours before the procedure was scheduled. After registering at the hospital, I was brought to Labor & Delivery. Once there, they set me up on a monitor in a hospital bed where they monitored the baby's heart rate and any possible contractions I was having for about an hour. They also inserted a hep-lock in my left hand in case they needed to administer IV fluids in the event of an emergency. The procedure would begin as soon as the operating room was open; they want to be sure it's open in case there are any complications and I'd need to be rushed in for a c-section.

Once the initial period of monitoring was over (and it was found, as they had expected, that everything looked normal on the monitors) the doctor came in to check on her position with an ultrasound machine. Sure enough, there she was - her little head right under my ribs! They gave me an injection of terbutaline in my arm in order to relax the uterus to prevent contractions. A side effect of this drug is that it can make you feel a little jittery; honestly, I didn't notice that too much because I was a bit jittery anyway from being so hungry! They waited five minutes for the drug to take effect, then the doctor came back in with two nurses to start the ECV.

They arranged the hospital bed so that I was laying almost completely flat. After covering my belly liberally with the aquasonic ultrasound gel, and using the ultrasound machine to get a good idea of her exact position, the doctor used his hands to try and move her head down from the outside. I felt a lot of pressure, and it was definitely uncomfortable, but I wouldn't say that it was painful in the slightest! After literally less than a minute, the doctor said, "Ok!", and checked with the ultrasound machine to show that she was now head down! The nurses were shocked at how quickly it happened; they'd never seen one work so quickly before. He did a few other checks to make sure that her head (and not her umbilical cord, for example) was the lowest part visible on the ultrasound machine, and then I was hooked up to the monitors again for another hour to make sure she was still doing fine, which she was! After that, I was wrapped up in a "binder" they often use for c-section patients to help discourage her from turning back to breech (approximately 2-5% of babies will turn back to breech after a successful ECV), which I'm supposed to wear 24/7 until labor begins. After that, I was discharged and sent home!

I am so happy I decided to go through with the ECV. For anyone who is faced with the possibility of this procedure, I wanted to be sure to put another "success story" out there for them to read. I had a few things in my favor: she's not my first baby, my amniotic fluid levels were good, she was anterior, and not engaged in the pelvis yet. These things helped increase my chances of a successful ECV. But going from this experience, it is definitely something I would recommend a mother seriously consider if she's offered one. For me, it was quick, painless, and ended up with a healthy, head-down baby! Thanks be to God!!!

"Pray, hope, and don't worry. Worry is useless. God is merciful and will hear your prayer." - St. Pio of Pietrelcina, one of my favorite Saints.

30 weeks!

30 weeks today! I'm very excited and grateful to God. Each day gets closer to the day our baby girl is born, and I can't wait! For me, there's just something about hitting 30 weeks that makes everything seem more "real," in a sense. I love it!

At our last ultrasound, we got a little glimpse of our beautiful baby girl. She had her hands in front of her face the whole time, so they didn't get a very clear picture, but ....

Here she is! I love those 3D ultrasounds! What a gift! I remember our 3D ultrasound pictures with Travis; I have one of them framed. Even now, when he's sleeping, it still looks exactly like him. Amazing!

Other than that, nothing has really been new here. We've been enjoying the weather immensely and Travis loves being able to go outside and play. He's getting so big! Walking down stairs (usually with some help from me, but recently he's accomplished a few stairs at a time without help!), "helping" in the kitchen and with laundry, opening doors...I just can't believe it. It's really amazing, watching my little baby boy growing up. I love every second!

Let's talk about hypothyroidism

I love to give encouragement to people from my own experiences, because I receive a lot of comfort hearing about others' life experiences and how they have dealt with issues in their lives. So I wanted to talk about something many of you probably don't know about me, but may give encouragement to others who are going through the same issue.

I was diagnosed with hypothyroidism in May of last year. Hypothyroidism, basically, is an under-active thyroid gland. I knew it was a possibility, as I have a strong family history. It affects approximately 17% of women before age 60 and 8% of men before age 60 in America, so it's a fairly common condition, even though it's estimated that three quarters of those suffering from it don't know they have it and have never been treated. What I didn't realize, however, what just how often it affects postpartum women.

When my son was 7 months old, I was feeling extremely tired, more so than usual for a new mom caring for a young child. Combined that with the fact that my memory seemed foggy, I felt colder and more irritable than usual, and I couldn't lose those last few pesky pregnancy pounds, I realized that there had to be something wrong.

I did a little research and came upon what is called "postpartum thyroiditis." It's an inflammation of the thyroid that occurs after childbirth. It can last several weeks to several months, and often manifests itself through hyperthyroidism (over-active thyroid) at first and then turns into hypothyroidism, for which the symptoms are more noticeable. The "hypothyroidism phase" usually takes place anywhere from 4-8 months after delivery, and can last for 9-12 months. This is usually when women see their doctors, but many women chalk up the symptoms they experience to caring for their baby. The symptoms can include fatigue, weight gain, constipation, dry skin, depression, foggy memory, inability to concentrate, irritability, poor exercise tolerance, hair loss, weakness, tightness in the throat, goiter, and sensitivity to cold.

Postpartum thyroiditis occurs in approximately 5-10% of postpartum women, but some believe the numbers are higher, since women may not see their doctors about it (thinking their symptoms are due to caring for a young child) and eventually, about 12-18 months from the onset, it goes away. Interestingly enough, however, approximately 20-25% of women who experience postpartum thyroiditis go on to have permanent hypothyroidism. And women who have experienced it after one pregnancy have an increased chance of it occurring after subsequent pregnancies.

I went to my doctor and requested the TSH blood test, for which the results showed I did, indeed, have hypothyroidism. While no one wants to have something wrong with them, I must admit I was relieved to know I knew my body well enough to identify a problem that wasn't simply imagined. It was later discovered that my form of hypothyroidism is called Hashimoto's disease or Hashimoto's thyroiditis, and it's permanent. I am currently taking daily thyroid hormone replacement medication which quickly helped me lose the rest of my pregnancy weight (and then some!) and has made me feel SO much better!

Thyroxine, the main hormone secreted by the thyroid gland, is so important for correct bodily functions, especially associated with pregnancy and breastfeeding. Women who have untreated or undertreated hypothyroidism during pregnancy can risk fetal abnormalities, low IQ in the baby, possible cognitive/developmental problems in the baby, recurrent miscarriages, risk of stillbirth, and preterm labor. (These are not an issue when a woman's thyroid is being correctly treated, however, so don't worry if you are pregnant and on thyroid medication!) Women who have hypothyroidism and discover they are pregnant should see their doctor immediately; they may need their dosage increased as early as the first four weeks of their pregnancy. Your doctor will closely monitor your thyroid levels throughout your pregnancy and adjust your medication as needed; usually you will receive an increase at some point in your pregnancy (or at various points) but often women find they can go back to their original dosage shortly after delivery. Hypothyroidism is also linked to low milk supply, so it's important that a woman who plans on breastfeeding be correctly treated for her problem. Usually when a woman is kept on the correct dosage of her thyroid medication, she is able to breastfeed without any difficulties. Your doctor will monitor your TSH levels and adjust your medication, if needed, at regular intervals.

Since synthetic thyroid hormone is virtually identical to thyroxine, it's perfectly safe to take throughout pregnancy and breastfeeding.

I personally believe that thyroid testing should be a routine part of every postpartum woman's evaluation. In the United States, gestational diabetes, a condition which occurs in approximately 3-15% of pregnant women, is routinely tested for in pregnant women around the 28th week. But why is a condition which occurs in roughly the same percentage of women, like postpartum thyroiditis, not routinely tested for? Even if the condition is not permanent, a woman could certainly benefit from medication (especially if she's experiencing trouble with her milk supply) and the large number of women who go on to develop it permanently, or go on to develop it after subsequent pregnancies, would seem to indicate it's something important to discover and diagnose. Not only that, but the symptoms are extremely unpleasant and distressing for a woman to experience, especially when she's caring for a young child. Just to know it's a condition that can be treated easily and often with great success can give hope and encouragement to these women.

If you're a woman who believes she may have postpartum thyroiditis, or any form of hypothyroidism, I'd urge you to see your doctor. The TSH blood test is quick and simple. The standard for the normal TSH range has been between 0.5-5.0, but in 2002 the American Association of Clinical Endocrinologists changed the standard to between 0.3-3.0 (which could actually double the number of people who are considered to have abnormal thyroid function.) Your doctor, especially if they are not an endocrinologist, may not be aware of the changes. If you are experiencing any of the symptoms I listed above, I'd suggest you see your doctor to rule out any thyroid abnormalities.

If anyone else has experienced this condition, I would love to hear your story! It's always nice to know that someone else has gone through, or is going through, a similar situation, so if any moms with hypothyroidism are reading this, I want you to know: you're not alone! :)

Contraception in the News

It's been a while since I've posted; I guess I've been busy with a lot of things lately! As always, I'll try to keep up with my blog more. It's never fun to come across a blog that's outdated!

There are so many things I could write about since my last entry, but the one thing that stands out the most to me has been contraception in the news. By now you must have heard of the HHS "contraceptive mandate," which would force Catholic institutions to cover contraception (including the "morning after" pill and other abortifacients) and sterilization.

Another interesting news piece was the decision of Susan G. Komen for the Cure to "defund" grant money given to Planned Parenthood; a decision which was lamentably reversed amidst backlash in the media and from pro-choice groups. This decision to "re-include" Planned Parenthood in their grants has sparked the resignation of their senior vice president for public policy. Why an organization dedicated to the eradication of breast cancer would give money to the country's largest abortion provider, an organization that admittedly does not provide mammograms and freely distributes birth control pills which are considered a class one carcinogen by the World Health Organization and have been shown to increase the risk of breast cancer, is beyond me.

But the bigger issue is something else in regard to artificial contraception, and it's been brought out mostly by the news of the HHS mandate. It seems as though most women, even Catholic women, don't realize that the Catholic Church, from her earliest days, has always been categorically opposed to artificial contraception. People in the news have been throwing out all sorts of statistics, mostly along the lines of: "95% of Catholic women have used contraception at one time or another." Yes, and unless they are using it for medical reasons unrelated to avoiding pregnancy, those 95% of women (which is certainly inaccurate) are disobeying Church teaching. To use artificial birth control as a means to avoid pregnancy is considered a grave sin. I could sit here and write for days on the Church's teaching regarding artificial contraception and the true purpose of our God-given human sexuality. Because I obviously don't have the time, here is a good article on the Church's teaching regarding marriage, sexuality, and artificial birth control: http://www.ewtn.com/library/marriage/cclbc.txt (I will add here, again, that it is not sinful for a Catholic to be on artificial birth control for therapeutic, i.e. "medical", reasons unrelated to avoiding pregnancy. The Pill is often prescribed by doctors to remedy "female problems." That being said, however, I would strongly urge a woman who has been prescribed the Pill for medical reasons to consult a trained NFP doctor. Artificial birth control only masks the symptoms associated with various female reproductive system issues; it does not cure them. A trained physician can help you get to the bottom of the problem and treat the issue itself and not just the symptoms. I know many doctors who do not believe a woman EVER needs to be prescribed the Pill for any medical issues, and I know countless women who have benefited from their help. If you need more info, please let me know.)

So, does that mean Catholics are required to have 10+ children if they're biologically able?!

The Church recognizes the fact that there are legitimate reasons for a couple to avoid pregnancy for a time (although a Catholic marriage, in order to be valid, must be open to life; see CCC 2366-2367). The Church has acknowledged Natural Family Planning as an acceptable means for a couple to avoid pregnancy for a time, if they have serious reasons for doing so (and there are many and varied legitimate reasons). I sincerely wish all this talk of Catholics and contraception in the news would bring up the subject of Natural Family Planning; unfortunately, I haven't even heard a single mention of it.

So, for those who aren't familiar, what is Natural Family Planning, also known as "NFP"? Well, it's certainly not the "rhythm method", contrary to popular belief. NFP simply consists in a woman recognizing the concrete and scientific signs of her window of fertility each month, which is taught according to a specific method, and using that information to try to conceive a child, or in the case of avoiding pregnancy, to abstain from sexual activity during that time. There are many methods of NFP, all of which are very scientific and very reliable. In fact, a recent study showed one form of NFP to be as effective as the Pill in avoiding pregnancy. Why one woman chooses one method over another is simply a matter of preference; all the ones you'll find from the websites I've listed below are well-documented and effective.

For anyone who is interested in learning more about NFP and its different methods, please take a look at these websites:

http://www.livingthesacrament.com
http://www.creightonmodel.com/
http://www.boma-usa.org/
http://ccli.org/
http://nfp.marquette.edu/
http://www.nfpandmore.org/index.shtml

A New Year...

Happy New Year to everyone!

This year has already been such a joy. Not only did I get to celebrate the beginning of 2012 with my wonderful husband, my precious son, and our sweet new baby on the way, but we had the great happiness to discover via ultrasound that our new baby is a GIRL! We are over the moon! Here's a picture of our baby Clare:


I know lots of people wait until birth to find out the sex of their baby, but both my husband and I love the idea of being able to call, and pray for, our baby by name. I know some moms feel like the excitement naturally wanes with each subsequent pregnancy, but even before I knew Clare was a girl I felt just as excited for this baby as I did when I was pregnant with Travis. I had spent most of my life thinking I would be a nun for the rest of it, and after discovering my vocation to marriage, being graced with the gift of motherhood is more joy to me than I can possibly express. I'm just thankful to God that no matter what happens, He saw fit to bless me with two precious children, a boy and a girl, and we will be open to His will in the future, which we hope includes many more little ones.

This year I hope to be very vigilant about incorporating the Faith into every aspect of our domestic life; not in a forced or pretentious way, but in a way that naturally flows from our firm convictions and loyal adherence to the Catholic Church. I read many other "Catholic Mom Blogs," and for each one I frequent, I'm blown away. These mothers are so inspirational! I love crafts, baking/cooking, reading, etc., etc., etc., and have always wanted to include these Catholic-themed activities in our daily life, especially as we plan to homeschool our children. But being a mom to a young toddler, with another little one on the way, makes me realize just how heroic these amazing moms are, most of whom have many more children than I do! More often than I'd like to admit, I lose the motivation to go forward on my Faith-themed activities because, well, "my son is too young to take part," or "there are so many other projects I could complete around the house first," or a whole slew of other reasons.

But I want my kids to grow up knowing these as fun, family traditions and if I'm not vigilant about doing them now, even if Travis is too young to take part or even remotely understand what they're all about, I know they'll slip through the cracks and it'll end up being "too late."

So, though we definitely have daily devotions and prayers we take part in and really do try to have a Christ-centered home, one of my "resolutions" this year for me as the heart of the home is to be extra vigilant in doing whatever I can to make the Faith fun, joyful, relevant, and concrete for my family members. There are many ways I can do that, but I'm going to put extra focus on one: The Kitchen! The kitchen is like my own personal "office space". It's probably where I spend the most amount of time working, and I actually LOVE to cook and bake, so it's almost therapeutic for me. Everyone knows the way to a man's heart is through his stomach, but I think that's pretty true for kids, too. What better way to make an impression about a particular Saint or Church Feast Day than with food?!

So I hope to be especially good about having special meals or desserts for feast days, and I'll try to take some time out to post some of the recipes here so you can take part in them, too. The internet is a great resource to find some fun and interesting "Catholic" recipes, but if you prefer a book, here's one the Sisters used a lot: A Continual Feast, by Evelyn Birge Vitz.

I'm also going to try to have a few fun Catholic craft projects to do each week, if only as a "practice run" for when my children can join me in making them. Now is the perfect opportunity to see which projects are great, and which ones should be shelved in favor of a different one. And now that we finally have a printer that works (horray!) I can print them out and organize them in a binder so we can make them a tradition each year. I'm excited! And thankfully I've gotten very good at time management, so I'll have the time to complete them.

I hope all of you have a wonderful 2012. May God abundantly bless each of you and your loved ones this year!

Merry Christmas!

As we are getting ready for our trip to visit relatives for Christmas, I know I won't be updating my blog before the beautiful, blessed holy day comes.

So I wanted to wish everyone a HOLY, MERRY CHRISTMAS!, and God's abundant blessings for you in the New Year!

And remember, Christmas doesn't end on December 25th -- it only just begins! Enjoy the entire Octave of Christmas with your family; do at least one thing special each day to celebrate! It is truly fitting to celebrate the birth of our dearest Lord and Savior in such a way.